Provider Demographics
NPI:1659962439
Name:IWODI, ENOCHE LINDA
Entity Type:Individual
Prefix:
First Name:ENOCHE
Middle Name:LINDA
Last Name:IWODI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10014 BRANCH VIEW CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1617
Mailing Address - Country:US
Mailing Address - Phone:682-331-9302
Mailing Address - Fax:
Practice Address - Street 1:10014 BRANCH VIEW CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1617
Practice Address - Country:US
Practice Address - Phone:682-331-9302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNA0000812760376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide